Is Literacy a Factor in “The Autism Epidemic?"

Most authorities accept that some part—if not necessarily all—of the increase in autism spectrum disorder (ASD) in modern Western societies is attributable to improved diagnosis, and especially to greater awareness of high-functioning forms of ASD, such as Asperger’s syndrome. But an earlier post suggests that there may also be a more fundamental, cultural factor involved where diagnosis of ASD is concerned.

What I have in mind here is the finding that what you might call the language of mentalism—the ability to describe mental states in words—has evolved with advances in literacy.

English provides a telling example, thanks to the fact that historical development in its vocabulary is clearly revealed by its evolution from Germanic Old English (before 1150) via Middle English following the Norman Conquest (1150-1350) to late Middle English (1350-1450). Simple speech-act and mental verbs like believe, know, mean, say, tell, think and understand are Old English except for the last, which is early Middle English. More specialized, Latinate verbs such as claim, conclude, confirm, declare, define, deny, discover, doubt, imply, interpret, prove and remember are all Middle English, with assert dated to 1604, concede to 1632, contradict to 1570, criticize to 1649, hypothesize (which is Greek) to 1596, observe to late Middle English, predict to 1546 and suggest to 1526. As Olson and Astington comment, “The simpler set of verbs, say, tell, and the like are used for talking about what a person says and what he means by it; the more elaborated set are used for talking not only about what a speaker says, but also about texts and their interpretations.”

And as I pointed out in a previous post, nineteenth and twentieth century novels appear to have taken the process much further and to have carried our modern language of mentalism into the realm of Freud, where every text becomes grist for interpretation—even that of a dream.

But now consider the implications for ASD. In a culture in which the language of mentalism is largely undeveloped, individual deficits in mentalism may be much less noticeable than they might be in one like our own, where the language of the mind has become highly elaborated and where cultural expectations and understandings have become extensively mentalized at the level of the individual. Those affected with severe forms of ASD would of course stand out in any culture, but the probably much greater number with milder forms of autism might be much less noticeable than they would be today. On the contrary, the relatively simpler collective mentality and less complex social life of people in traditional societies might be much less challenging for individuals with mild mentalistic deficits than is the comparatively chaotic and complex society of today. Such mildly autistic individuals might get reputations for being rigid, insensitive, or eccentric, but they would not be identified as mentally ill in a culture in which mental illness was not known—least of all known in the quite sophisticated ways in which our culture has come to think of mental illness since the “Freudian shift” began in the late nineteenth century.

The author of a remarkable study of Jane Austen’s astonishingly perceptive depiction of ASD in Pride and Prejudice(above) makes a similar point in relation to modern women’s expectations regarding marriage and the way in which, by contrast to the early nineteenth century, today’s society might make even mildly autistic men seem much more dysfunctional as husbands than they did then. Essentially, the reason would be same: it might simply be that modern women have not only greater expectations of their partner's responsiveness to them, but a much more elaborated mentalistic language in which to express it—including Freudian concepts like narcissism, regression, and reaction-formation, not to mention political ones like sexism, social exclusion, and chauvinism.

Equipped with such an armory of mentalistic complaints, mere males may feel vulnerable to modern women, and even mildly autistic ones would find their behavioral deficits much more likely to be exposed than in a traditional, patriarchal society. And what would be true of wives and girl-friends would also be true of parents, teachers, and employers in a modern, highly mentalistically-literate society: they would not only be much more likely to notice autistic behavior, but would also have the means to articulate and express their reactions to it—and hopefully of course, not always negatively. But whatever the outcome, the observed “epidemic” of mild ASD would be inevitable, and males would predominate, just as they do!

Of course, this says nothing about the true causes of ASD, and certainly does not rule out the genetic and environmental factors to which I have drawn attention in previous posts and which only the imprinted brain theory can fully explain. Nevertheless, if this way of looking at things is correct, it would go a long way towards explaining why so many high-functioning autistic people may feel that their diagnosis is as much other people's problem as their own.

(With thanks to Graham Rook for bringing the literacy papers to my attention.)